Drug interactions
Enzalutamide + Mitotane
Severity: Major
Enzalutamide and Mitotane: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Mitotane is a strong CYP3A4 inducer with a very long half-life and can substantially reduce enzalutamide exposure. This may compromise anticancer efficacy, although enzalutamide's active metabolite is formed and cleared partly by CYP pathways, so effects are variable.
What this interaction means in plain words
Enzalutamide and Mitotane can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Enzalutamide belongs to Endocrine; Mitotane belongs to Oncology.
Why it happens
Mitotane induces CYP3A4, increasing enzalutamide clearance.
What to do
Avoid the combination where possible; if used, monitor treatment response and PSA closely. Induction persists for weeks after mitotane is stopped.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Enzalutamide
- Doravirine + Enzalutamide Contraindicated
- Elbasvir / grazoprevir + Enzalutamide Contraindicated
- Ensitrelvir + Enzalutamide Contraindicated
- Enzalutamide + Fostemsavir Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
- Enzalutamide + Lenacapavir Contraindicated
Other interactions of Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Enzalutamide with Mitotane?
MediHelp rates the interaction as major. Enzalutamide and Mitotane can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Mitotane is a strong CYP3A4 inducer with a very long half-life and can substantially reduce enzalutamide exposure. This may compromise anticancer efficacy, although enzalutamide's active metabolite is formed and cleared partly by CYP pathways, so effects are variable.
How serious is the interaction between Enzalutamide and Mitotane?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible; if used, monitor treatment response and PSA closely. Induction persists for weeks after mitotane is stopped.
What other medicines interact with Enzalutamide?
MediHelp also lists interactions of Enzalutamide with, for example, Doravirine, Elbasvir / grazoprevir, Ensitrelvir. The full list is on the Enzalutamide page.
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